OBJECTIVES: This study was conducted to estimate the incidence of abnormal liver function and risk factors in male employees of an industry in Ulsan City. METHODS: Five hundreds and seventy nine male employees were selected as the study cohort and 533(92.1%) of them were followed after one year. The blood sample was collected to test for AST, ALT, gamma-GTP, total-cholesterol, fasting blood sugar and a self-administered questionnaire on life style was done. General characteristics(age, marital status, educational level), job department, exposure status for organic solvents, life style(alcohol, smoking, exercise, diet), past history of liver disease, family history of liver disease, drug intake, HBsAg, blood glucose, total-cholesterol were considered as risk factors. The result of liver function test after 1 year follow-up was treated as dependent variable. The operational definition of abnormal liver function was as follows; those who had abnormal liver functions in the two repeated tests with one month interval. RESULTS: The annual incidence of abnormal liver function was 9.6 per 100 and age-standardized incidence was 9.5. BMI, alcohol, past history of liver disease, and meat intake were significantly related to the incidence(p<0.05). In multiple logistic regression analysis, BMI(RR=2.70, 95% CI=1.41-5.16) and alcohol(RR=1.98, 95% CI=1.08-3.60) were proved as the significant variables. By stratified analysis considering changing pattern of alcohol and BMI, the relative risk of the BMI normal-normal and alcohol intake high-high group was 2.24(95% CI=1.09-4.62) and that of the BMI obese-obese and alcohol intake high-high group was 5.66(95% CI=2.69-11.88) compared with that of BMI normal-normal and alcohol intake low-low group. CONCLUSIONS: The age-standardized annual incidence of abnormal liver function was 9.5 per 100 in male employees. Thus, an active effort for reducing alcohol intake and controlling BMI should be done to reduce the incidence.
Blood Glucose ; Cohort Studies ; Fasting ; Follow-Up Studies ; Hepatitis B Surface Antigens ; Humans ; Incidence* ; Life Style ; Liver Diseases ; Liver Function Tests ; Liver* ; Logistic Models ; Male* ; Marital Status ; Meat ; Questionnaires ; Risk Factors* ; Smoke ; Smoking ; Solvents ; Ulsan

Lung volume reduction surgery, resecting the most severely affected regions of emphysema, was designed to improve quality of life for selected patients with severe emphysema. We report a case of a 72 year old severe emphysema patient who received bilateral lung volume reduction surgery and showed marked improvement of quality of life and lung function.
Aged ; Emphysema* ; Humans ; Lung* ; Pneumonectomy* ; Quality of Life

Most of the basal cell carcinomas (BCCs) are effectively treated using standard conventional therapeutic modalities, but the complete removal of the tumor is difficult if the subclinical extension of BCCs is deep and wide. These difficulties are solved by Mohs micrographic surgery which provides the highest possible cure rates and the lowest normal tissue loss. Mohs micrographic surgery is an ideal method for the treatment of skin cancer in that it provides unsurpassed cure rates and maximum preservation of normal tissue by complete surgical margin control. We studied 40 patients with 40 basal cell carcinomas (22 primary, 18 recurrent) treated by Mohs micrographic surgery from January, 1992 through October, 1995 at Dong-A University Hospital. We evaluated the depth and lateral margins of excision by Mohs microgrphic surgery according to the anatomic locations, histologic type, size, and primary/recurrent state of basal cell carcinomas. There was no recurrence during follow-up period up to 3 years. We can draw the guidelines for complete surgical margin control out of our results. The guidelines are as follows. 1. The frist excision should be done with lateral safety margin of 2 mm in primary BBCs. 2. The frist excision should be done with lateral safety margin of 4 mm in recurrent BBCs. 3. The frist excision should be done with lateral safety margin of 4 mm in longer than 15 mm-sized BBCs. 4. The additional excision should be done with the every 2 mm lateral safety margin until the tumor completely removed. 5. The frist excision should be done with the surgical depth to periosteum, perichondrium especially in BBCs on nose.
Carcinoma, Basal Cell* ; Follow-Up Studies ; Humans ; Mohs Surgery* ; Nose ; Periosteum ; Recurrence ; Skin Neoplasms

STUDY DESIGN: This is a retrospective study for radiographically and clinically assessing nonunion after lumbar spine fusion. OBJECTIVES: We wanted to analyze the risk factors for nonunion that requires surgical treatment after lumbar spine fusion SUMMARY OF THE LITERATURE REVIEW: A diagnosis of the nonunion after lumbar spine fusion was made by using only the only radiologic images. The incidence of nonunion has been underreported because there are many asymptomatic patients. MATERIALS AND METHODS: The plain X-ray films were evaluated for 1317 patients who could be followed up more than 1 year after lumbar fusion. Nonunion was diagnosed at 1 year after fusion by instability seen on the flexion-extension radiograph and the clinical findings like as sustained pain and local tenderness at the surgical site. The risk factors we reviewed included age, the number of levels fused, associated diseases, smoking, alcohol drinking, the initial diagnosis, a previous history of spinal operation, infection, a clear zone and malposition of pedicle screws and metal failure. The relations between nonunion and the factors mentioned above were analyzed. RESULTS: Thirty-nine patients were diagnosed as having nonunion underwent reoperation and all had surgically confirmed nonunion. Smoking, infection and a previous history of spine operation had a significant influence on nonunion (p < 0.05). Clear zones persisting more than 1 year and metal failure also had a significant influence on nonunion (p < 0.05). Age, the number of fused levels, the initial diagnosis and alcohol drinking were not shown to influence the rate of nonunion (p < 0.05). CONCLUSION: A through clinical and radiologic evaluation is essential to diagnose nonunion, and this should not be done according to the radiologic images only. Risk factors such as a previous history of spine operation, infection, smoking, the development of a clear zone and metal failure all showed a statistically significant influence on nonunion. Additionally, preoperative and postoperative evaluation of these parameters is needed to achieve bone union.
Alcohol Drinking ; Humans ; Incidence ; Reoperation ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Spine ; X-Ray Film

BACKGROUND: Osteoporosis is one of the most serious side effects of long-term glucocorticoid therapy, but the mechanism of glucocorticoid-induced bone loss remains poorly defined. Glucocorticoid induces decreased bone formation and death of isolated segments of bone (osteonecrosis) suggesting that glucocorticoid excess may affect the birth or death rate of bone cells and thereby reduce their numbers. It has been known that reduction in bone formation is due to reduced proliferation in osteoblast precursor cells and reduced matrix synthesis in mature osteoblast. Here, we present evidence for dexamethasone-induced apoptosis on human bone marrow stromal cells (hBMSC). To understand the mechanism of glucocorticoid-induced osteoporosis, we investigated the effects of glucocorticoid on primary cultured hBMSC. METHEODS: Treatment with dexamethasone at the concentration of 10-9 M for 3~5 days significantly decreased cleavage tetrazolium salt WST-1 level/concentration by mitochondrial dehydrogenase in viable cells. Greater decrease was observed with higher concentration of dexamethasone (10-7 M, and 10-5 M). Apoptosis was measured by annexin V binding/propidium iodide using fluorescence-activated cell sorter (FACS) analysis and nuclear morphology stained with the fluorescence dye, Hoechst 33342. RESULTS: The level/concentration of apoptotic hBMSC (annexin V positive / PI negative) was increased with 10-9 M dexamethasone (1.2% to 5.3%) and further increased with 10-7 M, and 10-5 M concentration (11.7% and 12.5%, respectively). The same result was observed with Hoechst 33342 staining. CONCLUSION: These results indicate that glucocorticoid induces apoptosis on osteoblast precursor cell, hBMSC, and may contribute to decrease bone formation
Annexin A5 ; Apoptosis* ; Bone Marrow* ; Dexamethasone ; Fluorescence ; Humans* ; Mesenchymal Stromal Cells ; Mortality ; Osteoblasts ; Osteogenesis ; Osteoporosis ; Oxidoreductases ; Parturition ; Stromal Cells*

PURPOSE: Laparoscopic surgery has become the standard method of radical nephrectomy within the urological community. We compared the safety and efficacy of different techniques for laparoscopic radical nephrectomy (LRN) in a single medical center. MATERIALS AND METHODS: Between June 2002 and August 2007, we performed LRN for renal cell cancer in 45 cases by a transperitoneal approach (TLRN), in 21 cases by a retroperitoneal approach (RLRN), and in 32 cases by a hand-assisted approach (HLRN), and the results of each approach were compared. Surgical results such as operative time, estimated blood loss (EBL), transfusion rate, hospital stay, complications, and pathologic results were reviewed retrospectively and analyzed by one-way ANOVA. RESULTS: There were no significant differences in demographic data among the 3 groups. The pathologic reports showed clear cell type in 97 cases and chromophobe type in 1 case. For each group (TLRN vs. RLRN vs. HLRN), the mean operative time was 207.9+/-57.06 vs. 211.8+/-52.85 vs. 184.4+/-49.43 minutes, respectively (p=0.03); the EBL was 135.0+/-29.40 vs. 153.8+/-45.59 vs. 183.4+/-89.25 ml, respectively (p=0.14); time to oral intake was 2.3+/-0.79 vs. 1.2+/-0.54 vs. 2.6+/-0.84 days, respectively (p<0.01); and the hospital stay was 6.7+/-0.77 vs. 5.4+/-0.73 vs. 8.2+/-1.51 days, respectively (p<0.01). There were no severe complications. The pathologic surgical margins were all negative. CONCLUSIONS: LRN can be performed efficiently and effectively with the transperitoneal, retroperitoneal, and hand-assisted techniques. Operators may select the technique for LRN according to their own preferences. In our experience, RLRN may protect the organ from injury and promote the recovery of lifestyle because of the early recovery of bowel movement.
Carcinoma, Renal Cell ; Laparoscopy ; Length of Stay ; Life Style ; Nephrectomy ; Operative Time ; Retrospective Studies

A 34-year-old woman complained of left facial palsy and numbness on the left thigh that began two weeks prior with headaches. Brain MRI revealed ill-defined patchy T2 weighted high signal intensities in the right medial temporal lobe and thalamus without contrast enhancement. Ten days later, when she complained of sensory symptoms below the 7th thoracic cord, we found an enhancing lesion in the lower cervical cord on the MRI. The result from the brain biopsy was consistent with anaplastic astrocytoma.
Adult ; Astrocytoma* ; Biopsy ; Brain* ; Facial Paralysis ; Female ; Headache ; Humans ; Hypesthesia ; Magnetic Resonance Imaging ; Spinal Cord* ; Temporal Lobe ; Thalamus ; Thigh

A 34-year-old woman complained of left facial palsy and numbness on the left thigh that began two weeks prior with headaches. Brain MRI revealed ill-defined patchy T2 weighted high signal intensities in the right medial temporal lobe and thalamus without contrast enhancement. Ten days later, when she complained of sensory symptoms below the 7th thoracic cord, we found an enhancing lesion in the lower cervical cord on the MRI. The result from the brain biopsy was consistent with anaplastic astrocytoma.
Adult ; Astrocytoma* ; Biopsy ; Brain* ; Facial Paralysis ; Female ; Headache ; Humans ; Hypesthesia ; Magnetic Resonance Imaging ; Spinal Cord* ; Temporal Lobe ; Thalamus ; Thigh

PURPOSE: To report cases of the surgical removal of sub-Tenon triamcinolone acetonide to control increased intraocular pressure after sub-Tenon triamcinolone acetonide injection. CASE SUMMARY: Three patients had no response to maximal medical treatment to control suddenly increased intraocular pressure after sub-Tenon triamcinolone acetonide (40 mg) injection to treat diabetic macular edema. The anterior chamber angle was open in all patients, and there was no neovascularization in the iris or anterior chamber angle. Slit lamp biomicroscopy showed deposition of triamcinolone acetonide in the inferior sub-Tenon area. Intraocular pressure was decreased within the normal range without any medication after removal of triamcinolone acetonide precipitates. CONCLUSIONS: Surgical removal of sub-Tenon triamcinolone acetonide can be as a primary treatment option in cases of increased intraocular pressure which shows no response to maximal medical treatment after sub-Tenon triamcinolone acetonide injection.
Anterior Chamber ; Humans ; Intraocular Pressure ; Iris ; Macular Edema ; Reference Values ; Triamcinolone ; Triamcinolone Acetonide

A 32-year-old male who had infective endocarditis complained of photophobia and blurred vision in both eyes. Biomicroscopic examination and fundus examination revealed anterior chamber reaction, vitritis, optic disc swelling, and Roth spots. He was diagnosed with bilateral nongranulomatous uveitis and treated with topical steroid eye drops and posterior sub-Tenon injection of triamcinolone. His visual symptoms were resolved within 1 week, and inflammation resolved within 4 weeks after treatment.
Adult ; Diagnosis, Differential ; Echocardiography, Transesophageal ; Endocarditis, Bacterial/*complications/diagnosis ; Fluorescein Angiography ; Fundus Oculi ; Glucocorticoids/administration & dosage ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Male ; Triamcinolone Acetonide/administration & dosage ; Uveitis/*complications/diagnosis/drug therapy ; Visual Acuity